6th ICHNO Abstract Book

6th ICHNO 6 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 16 – 18 March 2017 Barcelona, Spain __________________________________________________________________________________________ page 67

post-chemoHT, whilst 2 patients (stage IVa, IVb) developed distant metastases 20 and 32 months post- chemoHT. 3 deaths have occurred at 6 months (stage IVc), 21months (stage IVb), and 31 months (stage IVc) post- chemoHT. Locoregional control and overall survival at 2 years was 100% and 86% respectively. At 2 years, reported late side-effects included hearing problems G2/3 (n=2), neck pain/stiffness G2 (n=2), vestibular disorder G2 (n=1), trismus G2 (n=1), depression G1 (n=2), diplopia G2 (n=1), watery painful eye G2 (n=1). No patients were feeding tube-dependent at 1 year. Conclusion Image-guided chemoHT with moderately accelerated hypofractionation and selective neoadjuvant TPF is associated with acceptable efficacy and late radiation- induced toxicities. PO-140 Long-term outcomes of surgery ± radiotherapy for salivary gland carcinoma at a single institution J. Williams 1 1 The Prince of Wales Hospital, Radiation Oncology, Sydney, Australia Purpose or Objective Salivary gland carcinomas are a heterogeneous group of tumours. Surgery remains the primary treatment modality of choice, with or without adjuvant radiotherapy (RT) for high-risk patients. The purpose of this retrospective audit was to review outcomes of patients treated for salivary gland carcinomas (SGC) at a single institution based on prognostic factors, and treatment modality. Material and Methods An Ethics approved (HREC11/040) head and neck cancer database was audited between 1971-2014. Patient eligibility criteria were: histologically confirmed diagnosis of primary SGC (newly diagnosed or recurrent), age ≥18 years, definitive treatment with surgery ± RT, or RT- alone. Primary outcomes were local-control (LC), ultimate-local control (ULC), cancer-specific survival (CSS) and overall-survival (OS). Secondary outcomes were rates of distant metastases. Time to events were estimated using the Kaplan-Meier method and log rank test, with P<0.05 considered significant. All analyses were performed using IBM SPSS version 23.0. Results Of the 298 patients with SGC, 161 met the eligibility criteria (n=145 newly diagnosed, n=16 recurrent). Ninety patients were male (56%) and median age at presentation was 63 years (range 21-88). Parotid gland was the most common location of primary tumour (70%). Twenty-four patients (15%) were node positive at diagnosis, and 58% and 29% of tumours were staged T1-2 and T3-4, respectively, with the remainder not staged or unknown. Five-year LC, ULC, CSS and OS were 71%, 88%, 72% and 63%, respectively. LC was significantly higher in patients with T1-2 disease, and ULC was lower in node positive and high-grade disease (p<0.05). CSS and OS were higher in patients with T1-2 disease, node negative, low/intermediate tumour grade and no peri-neural invasion (PNI). Absence of lympho-vascular invasion (LVI) was associated with increased OS (p<0.05 for all variables). Thirty-one patients developed distant metastases, rates of which were significantly higher in patients with T3-4 disease, node positive, high tumour grade, and PNI or LVI (p<0.05 for all variables). Rates of LC were significantly higher in patients given adjuvant RT (p<0.01). No other differences by treatment in survival outcomes were found. Conclusion While the addition of RT increased LC, patients with advanced stage and infiltrative disease continue to have

poor prognoses, with higher rates of local failure, distant metastases, as well as decreased survival. PO-141 Adenoid cystic carcinoma of the head and neck: solid growth pattern as an adverse prognostic factor J. Fonseca 1 , C. Viveiros 2 , E. Netto 2 , S. Esteves 3 , I. Fonseca 4 , P. Montalvão 5 , M. Magalhães 5 , F. Santos 2 1 Instituto Português de Oncologia de Lisboa Francisco Gentil- EPE, Serviço de Radioterapia, Lisboa, Portugal 2 Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Radiotherapy, Lisbon, Portugal 3 Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Clinical Investigation Unit, Lisbon, Portugal 4 Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Pathology, Lisbon, Portugal 5 Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Otorhynolaryngology, Lisbon, Portugal Purpose or Objective To analyse and report the recent experience of our center in patients with adenoid cystic carcinoma of the head and neck (ACC) treated with surgery and radiation therapy (RT). Material and Methods Retrospective and unicentric study of patients diagnosed with ACC between 2009 and 2014 treated at our institution. Data were obtained from medical records, pathology and radiology reports. We evaluated overall survival (OS), disease free survival (DFS) and locoregional control (LRC) calculated by the Kaplan-Meier method. Log- rank test was used for univariate analysis. Toxicity was recorded according to Common Terminology Criteria for Adverse Events v4.0 (CTCAE). Results Thirty-six patients were identified (53% male; 47% female). Median age at diagnosis was 63 years (range 18- 81 years). The subsite distribution was oral cavity, 42% (n=15); paranasal sinuses, 22% (n=8); major salivary glands, 19% (n=7); nasal cavity, 6% (n=2); other subsites, 11% (n=4). T Stage distribution was T1, 25% (n=9); T2, 22% (n=8); T3, 25% (n=9); T4a, 17% (n=6); T4b, 11% (n=4). Seventeen percent of the patients (n=6) had node positive disease and 6% (n=2) had distant metastases at diagnosis. The primary treatment was surgery in 33 patients (92%), while the remaining 3 patients received RT alone. Pathologically, 88% (n=29) of the patients had R1 margins (R0, 6%; R2, 6%), 70% (n=23) had perineural invasion (PNI) and 64% (n=21) had a non-solid growth pattern (solid growth pattern, 24%; not reported, 12%). Median time interval between surgery and radiotherapy was 56 days. Median radiation dose was 66Gy (range 60-72Gy) and it was delivered using either 3D-CRT (53%) or IMRT (47%). Nodal irradiation was performed in 8 patients (22%). Median overall RT treatment time was 48 days (range 39- 61 days). Median follow-up time for surviving patients was 41.7 months (range 17.4-84 months). Fourteen patients (39%) had disease recurrence. First site of failure was locoregional in 8 patients, distant in 5 patients and one patient failed in both sites. Two-year and 3-year OS were 80% and 70%, respectively. Two-year and 3-year DFS were 74%/56% and LRC rates were 89/69%, respectively. On univariate analysis, solid growth pattern was associated with worse OS (p<0.001), DFS (p=0.001) and LRC (p=0.008). Overall RT treatment time superior to 49 days was associated with worse DFS (p=0.01) and LRC (p=0.001), whereas PNI showed a trend to significance in predicting worse DFS (p=0.06). Both patients with distant disease at diagnosis are alive and have stable M1 disease, one with local progression. Most frequent reported acute adverse events were dermatitis and oral mucositis (grades 1-3).